Trinity Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

TRINITY VILLAGE, INC.

Practice address

6400 Trinity Dr
Pine Bluff, AR 71603-7802

Phone

(870) 879-3117

Fax

(870) 879-6422

NPI assigned

Feb 19, 2007

Last updated

Apr 20, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Christina Joanna Smith

Title

Administrator

Phone

(870) 879-3117

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Trinity Village Medical Center Other name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558405993. Details of each certification follow.

• CCN 045438 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 045438

Legal name

TRINITY VILLAGE, INC.

Doing business as

TRINITY VILLAGE MEDICAL CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 17, 2010

Last certification

Jan 16, 2025

Beds

94

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 12, 1973 in AR

Enrollment address

6400 Trinity Dr
Pine Bluff, AR 71603-7802

Nursing home name

TRINITY VILLAGE MEDICAL CENTER

Listed as

Trinity Village Medical CenterCCN 045438 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 17, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9475.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Trinity Village Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Trinity Village, Inc

  dba Trinity Village Assisted Living

  • Assisted Living Facility
  • Pine Bluff, AR
  • NPI 1831596659
  NPD tax ID
• Trinity Village,Inc. Doing Business As Trinity Village Medical Center

  • Skilled Nursing Facility
  • Pine Bluff, AR
  • NPI 1932236767
  NPD tax ID

Locations

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• John E. Harris, M.D.

  • Family Medicine Physician
  • White Hall, AR
  • NPI 1902888720

  Adp of the SNF, Corporate Officer

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Trinity Village, Inc

  dba Trinity Village Assisted Living

  • Assisted Living Facility
  • Pine Bluff, AR
  • NPI 1831596659
  NPPES parent name

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• John E. Harris, M.D.

  • Family Medicine Physician
  • White Hall, AR
  • NPI 1902888720

  Nursing home

  Care Compare affiliation
• Larisa Kachowski, MD

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1023214574

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1558405993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 TRINITY DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037802",
            "telephone_number": "870-879-3117",
            "fax_number": "870-879-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 TRINITY DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037802",
            "telephone_number": "870-879-3117",
            "fax_number": "870-879-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "JOANNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "870-879-3117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "314",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179904311",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING FACILITY LICENSE",
            "identifier": "314",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Village Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Nat Treadwell, BS
• Taylor Treadwell
• James Trice, M.D.
• Trifecta Care
• Trinity Village, Inc (Trinity Village Assisted Living)
• Trinity Village,Inc. Doing Business As Trinity Village Medical Center
• True Home Care LLC
• Michael Carlton Turley, RD, LD
• Angela Turner, APRN
• Jared Turner

• Skilled Nursing Facility in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.